Welcome to CXH anaesthetic department. This is a big friendly teaching hospital department providing services for several specialist areas including major head and neck surgery, neurosurgery and acute stroke services. There are many procedures you are unlikely to see anywhere else on your rotation. You will also be involved in providing critical care services and supporting the ICU so will be able to maintain and develop these skills.

The Daily Grind!

Lists are available on Cerner from around 1600hrs the day before but may be subject to change after this.

Patients for most elective operating will be admitted to the Elective Admissions lounge on 6W. It is best to arrive by 0730 at the latest. The first patient on the list should be sent for automatically at 0800hrs (but that is not always the case). Currently there are challenges with this process; missing notes and organisational difficulties are common. Do not be disheartened!

Major orthopaedic cases such as THRs may be admitted directly to main hospital wards, e.g. 7 South.

Angio. Suite - you may be attached to an interventional radiology list in the angio. suite. This is located on the 1st floor in the imaging department. Call 30777 the day before to find out what is listed. The department does not open until after 8am.

Neurosurgery: Most of you will be placed at CXH primarily to sign off your intermediate or high neuro module. Ensure that you contact the rota coordinator early if you feel you are struggling to achieve the requisite number of lists.

ENT/Head and Neck: There are several interesting head and neck lists in the hospital and plenty of opportunity to work on your airway skills. Mr Sandhu performs laryngotracheal reconstructions which you may not see elsewhere. Both the anaesthetists and surgeons who work on these lists are friendly and approachable which makes it a great learning environment. There are numerous ENT clinics running in the hospital which might provide opportunity to practice nasendoscopy – approach one of the ENT team to attend.

Regional: Dr Boyne Bellew is an excellent regional anaesthetist and performs US guided blocks with an interest in teaching and organising courses.

Emergency Cases

NELA audit forms should be completed for all emergency laparotomy patients

Booking and Requesting Leave

The department actively try and facilitate leave where possible but the rota is tight and leave requests must be placed at least 6 weeks in advance.

There are four slots each day for annual/study leave for 8844/8189 trainees. There are two slots each day for 8111 trainees.

Study Leave should formally be requested eight weeks in advance via Intrepid. Please also submit an online study leave request on CLW rota. We are generally quite flexible until the leave diary is closed prior to writing the weekly rota which is about three - four weeks before. This is a generous privilege which should not be abused and can be withdrawn.

Swaps should ideally be made before the rota is drafted, 3-4 weeks out as it creates extra work to move people around, but short notice swaps might be accommodated if there is no net change to the rota.

It is your responsibility to check that the online CLW rota is correct as this is always taken as the definitive rota.

ID Badges: This is on the ground floor, pathology block. If you arrive for your on-call in the evening and do not have your Security ID access card with you, a temporary one can be taken from the Security Office on the ground floor, near the main reception (from the side).

The department is in the process to have its own Security ID access cards for emergencies.

NHS Smartcard: Anaesthetics Office Manager Simona Eisvydyte is PIN unlocker and Custodian for the department. She can issue you with a temporary smartcard (with Doctor’s access) for a day (if you left yours at home) or while waiting for the appointment with the Smartcard Team to sort out your own smartcard.

Car Park Permit: Go to the front desk/main reception on the ground floor and show your ID access card and car registration number. The permit costs £10 per day or monthly payment of £66.67 for 30 days. If you want the payment to be taken monthly from your salary, please email staffcarparking@imperial.nhs.uk

You will get a ticket if you do not show your permit. Code for the car park is 4321.

It is not sure if your CXH parking permit can be used at other Imperial sites, thus please email Security directly at securityadmin@imperial.nhs.uk to enquire if you need to at some point. The email must be sent from your Imperial email address.

Locum shifts: Time to time the department is looking to cover on-call gaps or sickness absence. If you are interested in locum shifts, please speak to Simona, so she can add you to the locum distribution list. If you want to do the locum shifts after leaving the Imperial Trust, please contact Doctor’s Bank imperial.locums.admin@nhs.net 1 month before you leave to start a registration.

Cerner - On the desktops or in the start menu of the PCs attached to the anaesthetic machines is a link called ‘Cerner in Theatres’. The URL is http://170.71.159.29/Citrix/NotimeoutSSOWeb/ (this link will not log you out of Powerchart so you don’t have to keep logging in).

Consultants who are able to sign off module completions:

Neuro Module Airway / ENT

Dr Stewart Berry Dr Mala Siva

D Nieves Dorronsoro Dr Nicola Stranix

Dr Jason Wilson Dr Jim Poncia

Dr Ashwin Kalbag Dr John Myatt

Dr Vidhya Nagaratnam

Pain Module Orthopaedic

Dr Lena Ladas Dr Bruce Arrigoni

Dr Stephen Humble Dr Chris Whiten

Dr Ashwin Kalbag Dr Drinka Uzeirbegovic

Dr Nicola Stranix Dr Dejan Markovic

Dr Suneet NayeeTop of Form

Bottom of Form

Dr Daniel Horner

General module - any consultant who is an educational supervisor should be able to sign off.

The Hospital

Charing Cross is a large acute general hospital. It is part of the Imperial College NHS Healthcare Trust and one of Imperial College School of Medicine’s teaching hospitals. It contains The Kennedy Institute of Rheumatology, West London Neurosciences centre and Maggie’s cancer centre. It is a tertiary referral centre for complex surgery, plastic reconstruction and neurosurgery; as well as for head, neck and urological cancers.

As part of Imperial Healthcare trust it is a centre for Healthcare research namely in rheumatology and cancer research.

The Anaesthetic Department

The anaesthetic service is delivered by consultants, senior clinical fellows and senior trainees under direct supervision. Anaesthesia is provided for patients undergoing General surgical procedures, specialist ENT and Airway surgery, Urological (including gender reassignment and cancer) surgery, Plastics, Neurosurgical and Orthopaedic surgeries. Charing Cross Hospital is now the main site for Imperials’ chronic pain service with interventional procedures and clinics taking place.

As a trainee there is the opportunity to gain exposure to all of these surgical specialities as well as gaining experience in Regional techniques and anaesthesia for radiological procedures. The on call service is provided by a senior and junior registrar with support from consultants. Theatre, ED and ICU referrals are covered by this team on a 24/7 basis. Fellowships are available.

Weekly half day teaching is provided as well as monthly morbidity and mortality meetings. There is also an active Audit programme lead by Drinka Uzeirbegovic that everyone is encouraged to take part in.